AIDS Mortality Higher in Women With Depression
By David DouglasNEW YORK (Reuters Health) Jul 21 - In HIV-positive women, chronic depressive symptoms appear to increase the risk of AIDS-related death, researchers report in the July issue of the American Journal of Public Health.Dr. Judith A. Cook of the University of Illinois at Chicago and colleagues note that previous studies have shown an association between depression and immune system suppression and other negative health outcomes. However, the relationship between depression and HIV disease progression is not well understood.To investigate further, the researchers examined data on 1716 HIV seropositive women who, over a 7.5 year period, paid semi-annual visits to clinics at one of 6 sites.In all, 147 (9%) died from AIDS-related causes over the course of the study. Other causes, including accidents and non-HIV-related diseases accounted for the deaths of another 147 women.Women who had chronic depressive symptoms were more than twice as likely to die of AIDS-related causes than were women who had few or no such symptoms. These findings are line with those of another large multi-center study.Moreover, AIDS mortality was less likely in women who reported mental health service use. Among other factors that reduced mortality were being on a HAART regimen or on non-HAART combination therapy.Thus, Dr. Cook told Reuters Health, "we now have substantial evidence from two large, multi-site cohorts of HIV-positive women that depression treatment must be part of the best-practice standard of care for women with HIV.""Antiretroviral treatment alone," she added, "will not address the needs of a significant number of women with HIV." Such therapy, the researchers conclude, "must be augmented by appropriate and sensitive mental health treatment, particularly as HIV disease progresses."Am J Public Health 2004;94:1133-1140.